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PubMed1990

HLA or HLA-linked genes reduce birthweight in families affected by idiopathic recurrent abortion.

HLA typing was performed in 49 families, each containing at least one woman with a history of unexplained recurrent spontaneous abortion (RSA), and reproductive histories were recorded for the siblings. Abortion rate in sisters sharing two HLA haplotypes with the proband was significantly (p less than 0.01) increased, whereas abortion rates of brothers' wives seemed independent of the brothers' degree of HLA sharing with the proband. Birthweights of offspring of both the sisters and the brothers decreased with increasing HLA haplotype identity between the sibling and the proband (p = 0.05). The mean birthweight of infants of siblings sharing both parental haplotypes with the proband was 3158 g which was significantly (p less than 0.02) less than the average birthweight in Denmark (3417 g). Significantly (p less than 0.05) decreased mean birthweight in infants of brothers who were HLA-identical with the proband suggested that the disposition to growth retardation could be inherited with HLA also through the male gametes. It has been shown that, in their few successful pregnancies, women with RSA bear infants with a birthweight which is approximately 300 g less than normal. The present study demonstrated that the two obstetrical conditions, RSA and retarded fetal growth, share common genetic markers: HLA. It is suggested that HLA or HLA-linked genes causing growth retardation in fetuses are part of the putative complex of genes involved in the pathogenesis of recurrent abortion.

Abortion, Incomplete↗
PubMedDate not supplied

Cholecystectomy and endometrial cancer: a marker of long-term elevated estrogen exposure?

Excess hormones, both endogenous and exogenous, are implicated in the etiology of endometrial cancer. We considered whether having had gallstones or a cholecystectomy (surgery to remove the gallbladder), which are more common in women who are obese and who use exogenous hormones, might be a marker for high lifetime levels of estrogen. We conducted a population-based study of endometrial cancer cases and community controls in women aged 40-79 years. Participants completed an interviewer-administered questionnaire that elicited exposures prior to diagnosis or reference date, including history of gallstones and cholecystectomy, as well as reproductive history, lifetime body mass, smoking, postmenopausal hormone (PMH) use, and other risk factors. Compared to controls, cholecystectomy was associated with a 50% increased risk of developing endometrial cancer (odds ratio = 1.5 [1.1-2.0]). The relationship appeared to depend upon PMH user status; the association was observed only among never hormone users. Body mass index did not appear to modify this relationship. Having a diagnosis of gallstones was also associated with endometrial cancer, although to a lesser magnitude. Although other etiologic factors may play a role in the relation between cholecystectomy and endometrial cancer, the current analysis suggests that this association is attributable, at least in part, to the sharing of hormonal risk factors.

Adult↗
PubMed1990

High fertility of Old Colony Mennonites in Mexico.

Old Colony Mennonites in Mexico appear to demonstrate natural fertility, using no form of artificial birth control and apparently not attempting to limit family size. The resulting fertility is nearly as high as that of the Hutterites, although the Mennonites lack the communal economic system of the latter. Most Mennonites in Mexico migrated from Canada in the 1920s, and the largest single settlement, called the Manitoba Colony, is one of four in the state of Chihuahua. A 1967 partial census obtained data from 38% of the Mennonite households. Family size in the sample was close to that in a local survey taken in the same year. Available church records matched with census forms permitted verification of and corrections to 560 female reproductive histories. The median number of live births to women over age 45 years was 9.5, compared with 10.4 in the Hutterites. Age-specific marital fertility rates and birth intervals closely resembled those of the Hutterites.

Adolescent↗
PubMed1996

Evaluation of reproductive function in Turkana women with enzyme immunoassays of urinary hormones in the field.

The frequently reported observation that nomadic populations have lower fertility than their settled counterparts is often attributed to what are perceived as harsh, stressful conditions under which the nomads live. But the consequences of the hypothesized stresses for the reproductive biology or demography of these populations have been documented only a little. Traditionally, the Turkana of northwest Kenya are nomadic herders, but increasing numbers have settled on agricultural development schemes. We used an array of hormonal assays along with anthropometric indexes of nutritional status and interviews covering reproductive history, recent menstruation, diet, and health to compare reproductive function in nomadic and settled Turkana women. First morning urine samples were collected for three consecutive days during a series of surveys. Human choriogonadotropin (hCG; a marker for pregnancy), luteinizing hormone (LH; an indicator of ovulation), and pregnanediol glucuronide (PdG; an indicator of postovulatory luteal function) were assessed in the field with commercially available dipstick enzyme immunoassays. These assays along with the interview data allowed us to determine the reproductive status (e.g., pregnant or cycling, and if cycling, which phase of the ovarian cycle) of 166 nomadic and 194 settled Turkana women. The cross-sectional classifications allowed inferences of conception rates and normality of ovarian function. Follow-up surveys provided rates of pregnancy loss. Compared with the settled women, the nomadic women exhibited lower pregnancy rates and cycling nomadic women were less likely to show evidence of ovulation or luteal function. These results suggest that reproductive function of the nomadic women is diminished relative to the settled women. However, the settled women experienced a much higher rate of pregnancy loss, which may mean that their effective fecundability is in fact lower than that of the nomadic women. This study is the first to apply such a wide range of hormonal assays in the field. It demonstrates that field-based assays are feasible and robust and can play an important role in epidemiological and biodemographic studies, even in remote locations under conditions that would ordinarily be considered incompatible with on-site laboratory analysis.

Adolescent↗
PubMed1998

Basic psychopharmacology of antidepressants, part 2: Estrogen as an adjunct to antidepressant treatment.

Estrogen exerts profound effects upon behavior by interacting with neuronal estrogen receptors. Changes in estrogen levels over a woman's life cycle are linked not only to behavioral fluctuations, but potentially to the onset or recurrence of mood disorders. The modern psychiatric evaluation of women requires obtaining a complete reproductive history, including details of hormone treatments, while identifying reproductive events as triggers of affective disorder episodes. While guidelines for the use of reproductive hormones in psychiatry are just evolving, administration of estrogen as an adjunct to antidepressants is an exciting possibility for expanding the frontiers of psychiatry into the field of women's health.

Antidepressive Agents↗
PubMed2001

Characteristics of women with premenstrual dysphoric disorder (PMDD) who did or did not report history of depression: a preliminary report from the Harvard Study of Moods and Cycles.

We examined the characteristics of 33 women with a diagnosis of premenstrual dysphoric disorder (PMDD) who did (n = 19) or did not (n = 14) report a history of major depression. Five hundred thirteen older premenopausal women (ages 36-44) from a community-based sample completed a prospective evaluation of PMDD with daily records. The diagnosis of PMDD was confirmed in 33 women (6.3%), and 14 subjects met criteria for PMDD with no history of depression. Demographic characteristics, cigarette smoking, and menstrual and reproductive history of subjects with PMDD who did or did not report a history of depression were compared. Women with PMDD and no history of depression were more educated and more frequently had a marital disruption (p < 0.05). No significant differences were observed with respect to reproduction-related characteristics or past cigarette smoking. These preliminary data suggest the existence of characteristics particularly related to women who meet criteria for PMDD and have no history of depression. Given the significant psychosocial impairment commonly associated with PMDD symptoms and the existing data that support its classification and adequate treatment as a distinct clinical entity, further studies are needed to better identify predictors of this syndrome unrelated to a lifetime history of depression.

Adult↗
PubMedDate not supplied

Menopausal experiences and bone density of Mayan women in Yucatan, Mexico.

This cross-sectional study reports on the menopausal transition of Mayan women from Yucatan, Mexico. A total of 228 women completed the study, and 118 women were classified by history as postmenopausal; the others were premenopausal. Demographic information, reproductive history, physical examination, hormone concentrations, radial bone density, food samples, and history of physical activity were obtained. The average age at which menopause occurred by history was 44.3 +/- 4.4 years; this is reflected in the distribution of FSH levels by age. None of the women reported symptoms of hot flashes, and none recalled any history of significant symptoms associated with their menopausal transition. Hormone levels were similar to U.S. reference values with elevated FSH (66.6 +/- 29.1 mIU/ml), low estradiol (9.4 +/- 8.3 pg/ml) and estrone (13.3 +/- 7.8 pg/ml), E1 > E2, and normal levels of testosterone and androstenedione. BMD declined with age, and values were lower than reference values for United States women. Clinical evidence of fracture was not detected by history or physical examination even for those who were 20 years postmenopausal. The endocrine characteristics of menopause among Mayan women in Yucatan are similar to hormonal changes reported for women in the United States, but signs, symptoms, and apparent consequences are different in the two populations.

Adult↗
PubMed2004

A breast cancer prediction model incorporating familial and personal risk factors.

Many factors determine a woman's risk of breast cancer. Some of them are genetic and relate to family history, others are based on personal factors such as reproductive history and medical history. While many papers have concentrated on subsets of these risk factors, no papers have incorporated personal risk factors with a detailed genetic analysis. There is a need to combine these factors to provide a better overall determinant of risk. The discovery of the BRCA1 and BRCA2 genes has explained some of the genetic determinants of breast cancer risk, but these genes alone do not explain all of the familial aggregation of breast cancer. We have developed a model incorporating the BRCA genes, a low penetrance gene and personal risk factors. For an individual woman her family history is used in conjuction with Bayes theorem to iteratively produce the likelihood of her carrying any genes predisposing to breast cancer, which in turn affects her likelihood of developing breast cancer. This risk was further refined based on the woman's personal history. The model has been incorporated into a computer program that gives a personalised risk estimate.

Adult↗
PubMed1997

Vaginal flora changes associated with Mycoplasma hominis.

OBJECTIVE: The aim of this study was to investigate any association between vaginal carriage of Mycoplasma hominis and genital signs and symptoms, other microbial findings, and some risk behavior factors in women with and without bacterial vaginosis. STUDY DESIGN: Women who had attended two family planning clinics and a youth clinic for contraceptive advice were divided depending on the result of vaginal culture for Mycoplasma hominis and the occurrence of bacterial vaginosis. The study population included 123 (12.3%) women who harbored Mycoplasma hominis. Those 873 (87.7%) with a negative culture for Mycoplasma hominis served as a comparison group. In the former group, 50 (40.7%) had bacterial vaginosis, which was also the case in 81 (9.3%) of the women in the comparison group. The groups were compared with regard to genital signs and symptoms, results of vaginal wet smear microscopy and other office tests, vaginal flora changes as detected by culture, and other means and detection of sexually transmitted diseases. Any history of sexually transmitted diseases and other genital infections, reproductive history, use of oral contraceptives, and smoking habits were registered. RESULTS: Women who harbored Mycoplasma hominis had significantly more often complained of a fishy odor, had a positive amine test, a vaginal pH > 4.7, and clue cells than did the comparison group; all these statements were true before and after bacterial vaginosis had been excluded. Vaginal discharge was not significantly more often complained of, and a pathologic discharge was not more often detected in the Mycoplasma hominis carriers. Ureaplasma urealyticum occurred in 75% of the Mycoplasma hominis-positive women and in 59% of the comparison group (p = 0.001). The leukocyte/epithelial cell ratio did not differ significantly from that of the Mycoplasma hominis culture-negative controls. CONCLUSION: The study suggests that Mycoplasma hominis is associated with a number of genital signs and symptoms even after exclusion of bacterial vaginosis.

Adult↗
PubMedDate not supplied

Evaluation of the subfertile couple: the fine points.

The basic fertility evaluation depends more on the history than findings at the initial visit. The previous reproductive history of both partners, the duration of infertility in this union, frequency of coitus, and a complete menstrual history often point to the diagnosis and correct therapy. Previous medical records pertaining to the problem are another source of information, and recent studies such as semen analysis results, ultrasound and salpingographic reports should be sought; the actual films are preferable to the reports. Previous surgeries, thought to be unrelated to fertility, may have been performed--try to get the operative report. There are myriad drugs that can interfere with fertility in either gender; therefore, a thorough history of past and present use as well as environmental toxin exposure is necessary. Often the routine prenatal tests for titers against common viral illnesses which can cause fetal damage have not been performed. Specific ethnic groups will need special testing. No invasive test or therapy should be performed on the female partner in the absence of a recent semen analysis. Ovulation evaluation can take the form of a basal body temperature chart; it's free, doesn't hurt, and is accurate in detecting the presence of ovulation, except for the exact timing. The over-the-counter urinary LH detection kits are highly reliable in predicting the actual day of ovulation. Serial ultrasounds to do this are not cost effective. This paper will discuss these points and the commonly performed evaluations such as salpingography and endoscopy. Specific hormonal evaluations of the amenorrheic patient and those with suspected polycystic ovarian syndrome will also be discussed.

Female↗
PubMed1995

Reproductive and other factors and risk of epithelial ovarian cancer: an Australian case-control study. Survey of Women's Health Study Group.

Of the few factors known to be associated with epithelial ovarian cancer, the most consistently observed relate to women's reproductive function, although even here uncertainties remain. We have undertaken a case-control study involving personal interviews with over 1,600 women, the largest of its kind to date, to investigate further the associations between women's reproductive histories and other factors and the development of ovarian cancer. Cases were drawn from women diagnosed with epithelial ovarian cancer in 3 Australian states, Queensland, New South Wales and Victoria, between August 1990 and December 1993, and controls were drawn at random from the electoral roll, stratified by age and geographic region. Trained interviewers administered standard questionnaires to obtain detailed information about women's reproductive and contraceptive histories and other factors of interest, such as smoking and family history of ovarian or other cancer. Findings were based on data from 824 cases and 860 controls and confirmed the reduced risk of ovarian cancer associated with increasing parity and duration of use of the oral contraceptive pill (OCP), hysterectomy and tubal ligation. The strongest association of all was seen with use of the OCP for 10 years or more. An inverse association between ovarian cancer and age at first birth was observed, but this was not statistically significant. There were no associations between development of ovarian cancer and number of incomplete pregnancies, use of hormone replacement therapy or menstrual history. Among other factors considered, education after leaving school was negatively associated and high body mass index, family history of ovarian cancer, use of talc in the abdominal or perineal region and smoking were positively associated with occurrence of ovarian cancer.

Adolescent↗
PubMed1977

Familial cancer in the general population.

In the course of collecting samples of human milk for the National Cancer Institute, family histories have been assembled since 1971. Ages, causes of death, reproductive histories, and the history and age of occurrence of cancer were obtained for all first degree relatives of the proband's parents. Two thousand and ninety cancers were identified in 31,945 persons. Cancers were confirmed by pathology reports, hospitals' and doctors' records, or death certificates. Of the family lineages, 65.9% had no cancers and 8.0% had two or more. For all cancers taken together, clustering was not significant but there was significantly more observed than expected cancers in lineages with cancer of breast, ovary, skin, corpus uteri, stomach, rectum, lung and bronchus, or colon. Little or no excess was observed in lineages with leukemia, lymphoma, and cancer of the cervix or prostate. The relative risk of breast cancer was increased 1.5 times for daughters and 3.8 times for sisters of women with the disease.

Breast Neoplasms↗
PubMed2002

Does tubal sterilization influence the subsequent risk of menorrhagia or dysmenorrhea?

OBJECTIVE: To evaluate the relation between tubal ligation, change in menstrual cycle characteristics, and early follicular phase hormones. DESIGN: Cross-sectional analysis of women 36-44 years of age. SETTING: The greater Boston area. PATIENT(S): Nine hundred seventy-six premenopausal women with intact uteri. INTERVENTION(S): A comparison of women with and without a history of tubal ligation. MAIN OUTCOME MEASURE(S): Menstrual and reproductive histories were self-reported. Early follicular phase blood samples were obtained to assess FSH, LH, and E(2). We compared menstrual cycle changes from the first 5 years after menarche with completion of the baseline questionnaire in women with and without a prior history of tubal ligation. RESULT(S): Cycle length, cycle regularity, menses length, flow volume, dysmenorrhea, and hormone levels were similar in women with and without a history of tubal ligation. However, among parous women with a history of cesarean section, those with a tubal ligation >5 years ago experienced a marginal increase in volume of menstrual flow compared with women with no tubal ligation history. CONCLUSION(S): We found no significant change in menstrual cycle characteristics or hormone levels in women with or without a history of tubal ligation. However, tubal ligation may have a modest effect on the change in menstrual flow volume over time among parous women with a history of cesarean section.

Adult↗
PubMed2000

Spontaneous conception after a successful attempt at in vitro fertilization/intracytoplasmic sperm injection.

OBJECTIVE: To determine the incidence of spontaneous pregnancy in women who were not actively undergoing therapy after a successful attempt at IVF/intracytoplasmic sperm injection and to characterize its pattern of occurrence. DESIGN: Retrospective postal questionnaire. SETTING: An assisted reproduction unit at a university-based teaching hospital. PATIENT(S): Five hundred thirteen replies were received from 530 questionnaires mailed. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Spontaneous pregnancy. Women who did and did not conceive spontaneously after successful IVF treatment were compared in terms of their age, duration of infertility, previous reproductive history, and indication for treatment at the time of assisted reproduction. RESULT(S): The rate of spontaneous conception among the survey respondents was 20.7%. Younger women (</=34 years of age) had a higher rate of spontaneous conception, as did those with a shorter duration of infertility. Women with unexplained infertility and endometriosis also were more likely to conceive. Few of those who had undergone intracytoplasmic sperm injection conceived, whereas 21.6% of those whose partners had had sperm quality sufficient for IVF later conceived spontaneously. CONCLUSION(S): The chances of spontaneous conception after successful ART therapy are significant in some groups of patients. This has implications for the practice of assisted reproduction and the obstetric care of patients who conceive with treatment. Contraceptive advice may need to be provided to couples who undergo IVF/intracytoplasmic sperm injection.

Adult↗
PubMed2000

Consistency of temperament in bighorn ewes and correlates with behaviour and life history.

Individual differences in temperament may affect how animals react to novel situations, avoid predation, invest in reproduction and behave in a variety of social contexts. Little information is available, however, about individual differences in temperament for wild animals. For bighorn sheep, Ovis canadensis, ewes captured as part of a long-term study, we compared behaviour during handling to behaviour in the field and reproductive history. We considered 'bold' ewes those that were frequently trapped during the summer, and assigned to each ewe a docility index based on her behaviour during handling. Measurements of temperament for the same individual at different captures were highly consistent. Temperament was not affected by reproductive status or age, nor was it related to body mass. Correlations between behaviour at the trap and in the field were weak and mostly nonsignificant, suggesting that temperament is domain specific rather than domain general. Bold ewes tended to start reproducing earlier and have higher weaning success than shy ewes. Variability in temperamental traits in the study population could be maintained by life-history trade-offs and by yearly changes in selective pressures. Copyright 2000 The Association for the Study of Animal Behaviour.

Journal Article↗
PubMed2007

Risk of breast cancer associated with short-term use of oral contraceptives.

OBJECTIVE: To estimate breast cancer risk associated with short-term (<6 months) oral contraceptive use, and explore variation in estimates by use characteristics and medical, menstrual, and reproductive history. METHODS: We analyzed data from the Women's Contraceptive and Reproductive Experiences Study. Case subjects were white women and black women, 35-64 years old, diagnosed with invasive breast cancer in July 1994-April 1998. Control subjects identified by random-digit dialing were matched to case subjects by age, race, and study site. Conditional logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS: Overall, short-term oral contraceptive use was not associated with breast cancer risk (OR = 1.0; 95% CI = 0.8-1.1). However, significant interaction between short-term use and menopausal status led to an observed increased breast cancer risk in pre-menopausal women (OR = 1.3; 95% CI = 1.0-1.7) and a reduced risk in post-menopausal women (OR = 0.8; 95% CI = 0.6-1.0) associated with short-term use. The association was more pronounced in women with non-contraceptive reasons for use and underlying risk factors for breast cancer. CONCLUSIONS: These associations may result from underlying characteristics of users or unmeasured factors influencing duration of use and breast cancer risk.

Adult↗
PubMed1993

An evaluation of the influence of reproductive factors on the risk of metastases from uveal melanoma.

BACKGROUND: There is a paucity of data concerning the possible role played by hormonal factors in the risk of metastases from intraocular melanomas. METHODS: The authors studied the influence of post-diagnosis pregnancy and oral contraceptive use in a group of women of reproductive age (45 or younger) who were treated for uveal melanoma by proton beam irradiation. A baseline reproductive history had been collected before irradiation for all women, and interim reproductive data were collected by mailed questionnaire. RESULTS: In this age group, the overall rate of metastasis among women was similar to that of men treated during the same interval (adjusted rate ratio: 1.28; 95% confidence interval: 0.62-2.67). A total of 24 full-term pregnancies were reported among the 139 women still menstruating at diagnosis. Twenty-three women reported regular oral contraceptive use. Metastases developed in 15 of the 139 women. Compared with other women in the series, rates of metastases were not higher among the women who reported pregnancies (P = 0.932) or oral contraceptive use (P = 0.424) after diagnosis. CONCLUSION: Although based on limited numbers, results suggest that the hormonal environment has no appreciable influence on risk of metastases in younger women with uveal melanoma.

Adolescent↗
PubMed1986

Canine breeding management.

A prebreeding examination should be performed on animals of both sexes to ensure their optimal health at the time of breeding. At this time, the medical and reproductive histories should be reviewed to detect potential negative influences upon the reproductive tract. Serologic testing for canine brucellosis should be performed to detect and remove infected animals from the breeding program. Examination of the female reproductive tract may be limited to the caudal vagina, vestibule, and vulva. Defects that cause pain and reluctance to breed may be detected with thorough digital and visual inspection. The male reproductive tract can be examined along nearly its entire length without special techniques. Semen may be collected for initial evaluation of testicular function and fertility. Swelling of the vulva and a hemorrhagic vaginal discharge will alert the observant owner to the onset of proestrus. Vaginal cytology may be examined every few days after the observed onset of proestrus to determine the onset of estrus. Breeding should be performed by natural or artificial insemination every 2 to 4 days during estrus to achieve optimal conception rates. The bitch should not be exhibited or trained during the period of potential pregnancy. Unnecessary drugs should not be administered. A diagnosis of pregnancy may be made by abdominal palpation 28 to 30 days after the last breeding. Serum progesterone levels may be measured if pregnancy is not established to determine if ovulation occurred and if sufficient levels of progesterone are present to maintain pregnancy. Optimal breeding management techniques can often result in the maximum reproductive efficiency desired.

Animals↗